Tag: Diabetes

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Coffee…for diabetes, Parkinson’s, liver and more?

I love my morning coffee, so I “perk up” whenever I see a study that suggests this habit is a good thing! Are you a coffee lover too? Then read on…

Overall, coffee drinkers were found to have more health benefits than risks from their habit, compared to those who did not drink any coffee. The average daily intake in those who were studied was 3 to 4 cups per day compared to no coffee daily, although some studies looked at how health changed in the years after people increased or decreased their coffee intake by a cup or two.

5 Benefits of coffee

  1. Coffee and diabetes—a 2014 study followed over 123,000 people for 4 years. Those who increased their daily coffee intake by 1 cup per day had an 11% lower chance of developing Type 2 diabetes. Those who decreased their coffee consumption (by an average of 2 cups per day) had a 17% higher risk for Type 2 diabetes. Changes in tea drinking were not linked to diabetes risk.

  2. Coffee and Parkinson’s disease—Several studies suggest that caffeine, whether in coffee or other drinks, may help decrease risk of developing Parkinson’s. One analysis determined that men who drink 4 or more coffees per day may have 1/5 the risk of those who do not. Another study in 2012 suggests that the caffeine in coffee may help control movement in people with Parkinson’s. Another study in 2017, that found a link between coffee intake and Parkinson’s, also noted coffee drinkers may be less likely to develop depression and dementias like Alzheimer’s as well. However, there wasn’t evidence to show that drinking decaf coffee would help prevent Parkinson’s.

  3. Coffee and liver diseases—Researchers in Italy found that coffee decreases risk of liver cancer by about 40%. Their numbers suggest those who drink 3 cups a day may have 50% decreased risk of liver cancer. A different literature review in 2019 concluded that “coffee intake probably reduces the risk of liver cancer”. Another large analysis in 2017 found coffee also appeared to decrease risk of non-alcoholic fatty liver disease and cirrhosis, as well as liver cancer.

  4. Coffee and heart health—We often think negatively of coffee when it comes to heart health, since people are advised not to drink it just before measuring their blood pressure. But drinking coffee in moderation, two 8-ounce servings per day, may protect against heart failure (when the heart can’t pump enough blood to meet the body’s needs), according to a 2012 study. They found an 11% lower risk of heart failure in those who drank this moderate amount versus those who drank none. Another analysis in 2017 found that those who drank 4 to 6 cups of either caffeinated or decaf coffee daily appeared to have a lower risk of Metabolic Syndrome—in other words, they had lower blood pressure, lower blood cholesterol, and lower blood sugar—and this included a decreased occurrence of Type 2 diabetes.

  5. Overall health—An umbrella study in 2017, using combined data from 218 other analyses of studies, found coffee consumption seems generally safe within usual daily amounts. It showed the largest risk reduction in those who drank 3 to 4 cups daily and that coffee is more likely to benefit health than harm it. Mortality from any cause was reduced by 17% in these coffee drinkers.

An exception to the benefit of coffee is during pregnancy, when drinking more coffee could result in low birth weight of the baby (31% greater relative risk), increased risk of pregnancy loss (an increase of 46%) and increased chance of preterm birth (12-22%). Another exception is for women at risk of bone fractures (but not men for some reason…). Increased coffee was associated with an increased risk of breaking a bone only in women. Their recommendation was for women already at risk of a bone fracture to avoid coffee.

So, I guess I can happily continue my morning coffee—no risk of pregnancy for me and my risk of bone fracture is low! I usually enjoy 3 cups as I peruse the morning news and emails, and check Facebook for photos of what my wonderful granddaughters are up to! Hmmm…must be time for cup #3…

PLEASE NOTE: A little clarification on the numbers in this blog. The percentages in this article are “relative risk” numbers not overall risk. They compare risk with the factor to risk without it. For example, a relative risk increase of 50% could mean 10% without the risk factor have the condition compared to 15% with it…or 0.01 vs 0.015%. “Actual risk” numbers were not quoted in my references, only the percentage increase in risk.)

References:

Health benefits and risks of drinking coffee https://www.medicalnewstoday.com/articles/270202.php#benefits

Changes in coffee intake and subsequent risk of type 2 diabetes: three large cohorts of US men and women https://link.springer.com/article/10.1007%2Fs00125-014-3235-7

Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/

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Health

Chocolate lovers alert!

For years, we’ve been reading articles that suggest chocolate has a healthy side. It seems that the evidence is growing from studies around the world…

In Japan

A Japanese study followed diets of over 84,000 healthy men and women ages 44-76 for approximately 13 years. It found that regular chocolate consumption reduced risk of stroke overall by about 10% (when adjusted for other factors that influence stroke risk).

But, the risk for stroke was reduced more in women than in men, with 16% lower risk of stroke compared to a non-significant 6% reduction in men. Researchers could not explain the reason for this difference, and recommended further research to explain their findings.

In Sweden

Another study, done in Sweden, followed 37,000 men for about 10 years. These researchers found that regular high chocolate consumption (approximately 62 grams per week) was associated with a 17% lower risk of stroke, compared to no chocolate consumption.

A “meta-analysis” combining data from 5 similar studies, also conducted in Sweden, found a 19% reduced risk of stroke between those with the highest and lowest chocolate intakes. This group also identified a 13% reduction in myocardial infarction (heart attack) in those who consumed 3 to 4 servings or more per week of chocolate.

In USA

The Physicians’ Health Study followed 20,000 men, average age 66 years, for about 9 years. Their data suggested that moderate chocolate consumption might be associated with a lower risk of heart failure, with the reduction for eating chocolate 1-3 times a week being slightly better than 5 or more times per week. Improvement with chocolate held for those with lower body weight (BMI less than 25) but not for those who were heavier.

When chocolate intake is compared to diabetes risk, I would not have expected any benefit, since chocolate is sweet and sold as candy. However, I was surprised to read that the Physicians’ Health Study found the opposite: among those with a healthy weight and without a history of heart disease, intake of chocolate twice weekly or more (amount not indicated) reduced the risk of developing diabetes by 17%. They indicated that this correlation only applied in younger men of normal weight, after adjusting the numbers for lifestyle and total energy consumption. Sounds like the extra calories in the chocolate outweigh the benefits, once a person has diabetes or is overweight…

As an aside, I was astounded that many of these studies included only men… and therefore truly only apply to half the population. However, given that the first study I discussed found better results for women who consumed chocolate, it seems likely that the results of the other studies would apply to women as well.

The reductions in risk were not huge numbers but, the way I look at it, if you have a healthy lifestyle and diet, a little chocolate from time to time is a nice treat that won’t harm your health and might actually reduce your risk of heart disease, stroke and even diabetes!

So, go ahead and enjoy a modest amount of chocolate 2 or 3 times a week as part of a healthy diet, and don’t feel guilty… (but better to avoid it if you have diabetes or are working to reach a healthier weight).

References: Atherosclerosis, 2017 Mar 4;260:8-12

Neurology 2012 Sep 18;79(12):1223-9

Am J Clin Nutr 2015 Feb;101(2):312-7

Eur J Heart Fail 2014 Dec;16(12):1372-6

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Health

Could diabetes cause Alzheimer's?

Diabetes increases your risk of heart disease, stroke, and damage to blood vessels and nerves, but did you know that studies suggest it may also increase your risk of eventually developing Alzheimer’s disease and other forms of dementia?

And the damage to your brain may even start before you have diabetes…

Type 2 diabetes begins with spikes in levels of sugar in the blood, which trigger your body to produce higher amounts of insulin to process this sugar. At first the higher amounts of insulin can reduce blood sugar to normal (this stage is referred to as pre-diabetes) but eventually, as your body becomes increasingly resistant to the effect of insulin, blood sugar can no longer be controlled at normal levels, and you are diagnosed with diabetes.

Research is suggesting that these increased levels of insulin begin the process of damaging the inside of blood vessels and, in the brain, also stimulate formation of toxic proteins that damage brain cells. Researchers have discovered that the same protein that is formed in Alzheimer’s patients’ brains, is found in the brains of people with type 2 diabetes (T2D). T2D patients often experience a sharp decline in cognitive function and almost 70% of them eventually develop signs of Alzheimer’s or another dementia, according to http://www.alzheimers.net.

Melissa Schilling, professor at NYU, suggests that all patients with dementia or who are at risk of developing dementia should be tested for hyperinsulinemia (high insulin in the blood). She suggests that high insulin could be responsible for almost half of all cases of dementia. However, she recommends that further research needs to be done to verify her arguments and implications for treating Alzheimer’s. Her article: Unraveling Alzheimer’s: Making Sense of the Relationship between Diabetes and Alzheimer’s Disease was published in the Journal of Alzheimer’s disease in Jan 2016. Click here for the full text.

Research points to the protein, amylin, that is co-secreted with insulin and, along with the beta-amyloid protein, it is thought to be important in the formation of amyloid plaques found in the brains of Alzheimer’s patients.

Another possibly important factor, may be levels of insulin-degrading enzyme (IDE), the enzyme that breaks down insulin, reducing levels once it’s finished its job. The presence of insulin stimulates increased activity of IDE, the enzyme that breaks down insulin. Lower insulin leads to less activity of this enzyme. IDE also breaks down amyloid proteins, but it favours breakdown of insulin.

It may be an imbalance between IDE, insulin and amyloid-beta production that ultimately is shown to be a major cause of dementia. Here are 4 suggested scenarios:

  • Severe lack of insulin (as in type 1, insulin dependant diabetes), could lead to less IDE activity, and subsequent decrease in breakdown of amyloid proteins that create plaques in the brains of dementia patients.

  • Lack of production of IDE itself would lead to increased levels of both insulin and beta-amyloid

  • Excessively high levels of insulin (and amylin, secreted along with it) in early stages of type 2 diabetes could lead to competition for insulin-degrading enzyme between insulin and amyloid. Since the enzyme favours insulin, this would result in less breakdown of amyloid and increased amounts available for formation of plaque in the brain

  • An individual could produce higher than normal amounts of amyloid proteins that outpace the ability of IDE to break it down.

You can see how both a lack of insulin and too much insulin could be a cause of dementias. Too little insulin-degrading enzyme or increased production of amyloid proteins could cause problems in people with normal production of insulin. These confusing scenarios could explain why researchers have not yet determined the causal relationship between diabetes and Alzheimer’s, despite reporting on the connection as far back as 2003!

This type of research is especially important, as the drugs currently available to treat Alzheimer’s offer only small improvements in symptoms and do not stop the progression of the disease, in spite of their high cost.

So, ask your doctor to screen for early signs of diabetes and aggressively treat it when discovered to keep your insulin levels in the normal range. Eat a healthy diet and exercise regularly, as these are also known to lower the risk of developing diabetes. It seems likely that these strategies will lower your chances of developing dementia years down the road.

References: MayoClinic.org; Alzheimers.net

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Health

Type 2 diabetes – can it be reversed?

For years, studies have looked at ways to prevent Type 2 (adult onset) diabetes, and have identified a healthy diet and exercise can prevent it…but what about those who already have it? A new study suggests that it may be possible to reverse this destructive disease in the early stages, at least temporarily. This is important, given that treatments for diabetes lose their effectiveness over time, creating an ongoing struggle with gradually increasing medication to keep blood sugar levels under control.

People with type 2 diabetes were signed up to either an 8-week or 16-week intensive treatment program, or to usual care. The treatment included intensive lifestyle counselling (targeting weight loss) with frequent nurse and dietician contact, and treatment with insulin, metformin (a drug that increases sensitivity to insulin) and acarbose (a medicine that slows the breakdown of carbohydrates into sugar in the digestive system). The goal was to have blood glucose of less than 5.4mmol/l before meals and an average after meal glucose of less than 6.8mmol/ after 8 or 16 weeks.

Half of people in the 8-week group achieved these goals compared to only 3.6% of the control group, and 70% of the 16-week group reached the targets. The drugs were then discontinued in the treatment groups and their blood sugar was monitored.

What was really interesting, was that some people in the treatment groups continued to maintain blood glucose control even after the drugs and insulin were discontinued. Twelve weeks after the completion of the intervention, 21.4% of the 8-week group and 40.7% of the 16-week group met criteria for complete or partial diabetes remission, compared to only 10.7% of “controls” who had received only the usual care.

These results suggest that an intensive diabetes treatment strategy delivered over 2 to 4 months may induce remission of type 2 diabetes. Of course, further research needs to be done in the area to confirm the results, especially as this was only a short-term study, but it’s encouraging to see that the effects of 8 to 16 weeks of treatment can continue for several months, at least in some people with diabetes.

Since the intervention also intensively targeted lifestyle and weight loss, the remission of diabetes could be due at least in part to these factors; I would like to have seen a comparison of drug intervention with an intensive lifestyle and weight loss group rather than only with usual care. However, any study into possible ways to reverse diabetes is valuable, given the increasing rates of diabetes that are occurring now.

This study was published in the Journal of Clinical Endocrinology and Metabolism on March 15, 2017 (N.McInnes, et al; Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial).